American contact tracing apps: What are the options and why aren't they working

Contact tracing, the process of determining who has recently been in contact with a person infected with a virus, is considered to be one of the best methods for controlling the spread of the novel coronavirus. For now, the monitoring process is split into two groupings: Systems anchored by people or systems anchored by apps. In some nations, apps have been successful. This hasn't been true in the United States.

Covidwise could potentially change our luck. Launched in August, it is the first exposure-notification app in the US that uses technology from Apple and Google. It works in Virginia and other state's health departments are launching similar apps soon.

Covidwise is a bare-bones experience, as far as apps go. If you’re used to apps like Twitter, Instagram, FaceApp, TikTok, or other popular social media experiences, it’s almost jarring: here is an app that doesn’t try to make you stay longer, that doesn’t try to hook you in with bells and whistles. It simply wants to know if you’ve gotten a positive result on a coronavirus test.

What is Covidwise?

It’s hard to tell the new app’s effectiveness in New York, where I’m located. Built by the Virginia Department of Health, with an assist from local analytics company SpringML, the app comes almost four months after Apple and Google put aside phone and app store fights to build a framework that public health departments around the globe could use for contact tracing.

The state’s health officials, like Virginia State Health Commissioner Dr. M. Norman Oliver, strongly endorsed the app in press statements:

“Covidwise will notify you if you’ve likely been exposed to another app user who anonymously shared a positive COVID-19 test result. Knowing your exposure history allows you to self-quarantine effectively, seek timely medical attention, and reduce potential exposure risk to your family, friends, neighbors, and colleagues."

The idea behind Covidwise and apps like it have the best intentions, and science backs them up. But Covidwise and apps like it, which seek to put contact tracing into action, are struggling to make a dent in America.

What is contract tracing?

You might have heard this term on the news, or mentioned by the CDC. During the first part of the year, as medical experts around the world struggled with the stunning spread of Covid-19, it quickly became apparent that the virus could spread from person to person with remarkable ease.

So scientists turned to an old, and occasionally controversial tool: contact tracing. To fight coronavirus and other pernicious diseases, the technique can help us learn where someone contracted the virus and from who. When the web of a coronavirus infection is exposed, doctors can encourage someone who has the potential to spread the disease to stay isolated, slowing the spread.

Contact tracing has been helpful in past fights, like when doctors put out the call to “find the mission million” in the 1940s to fight venereal disease. But it’s also broken down in the past, too: when fighting HIV and AIDS in the 1980s, homosexuality was still illegal in many states. At a moment when sickness was associated with an illegal act, activists were deeply suspicious of making lists.

How does Covidwise work?

Covidwise, and apps like it around the country, work under the principles that Apple and Google have determined. Using the Bluetooth technology that’s available in all smartphones, the app relies on invisible handshakes between one person and another. If Person A tells their Covidwise app that they have gotten a positive result on a Covid-19 test, their phone sends out a completely anonymous date-based Bluetooth Low Energy (BLE) signal.

The signal looks for a matching signal, a similar BLE signature based on date. If they’ve found a matching signal in the timeframe of 15 minutes and within six feet, then Person B gets a notification of possible exposure.

The app tries to promote privacy at every turn. SpringML’s press release excitedly notes “No names! No location!”

Why are contact tracing apps not catching on in the US?

Care19, an app very similar to Covidwise in South Dakota, has struggled to be useful in any capacity. While these apps have had some success abroad, like in South Korea and Ireland, they have not made the noticeable dent in the US.

What gives? In a sense, these apps have two hands tied behind their back. On one hand, they are working to fight the perception of government surveillance — and the United States has a long history of surveillance. To fight this perception, apps like Covidwise and Care19 do their best to stay completely anonymous and opt-in, meaning that after downloading the app users have to actively tell it to start collecting BLE signals. Most people do not do this: Studies have shown that opt-in apps have success rates hovering around 42 percent.

On the other hand, technology companies, like Google and Apple, have surveilled people for years. The amount of data that any large tech company has on its users would envelop the amount of data that state governments are trying to collect through these apps. Before coronavirus, these long histories of surveillance meant that roughly 6 in 10 believed that it was impossible to get through a typical day without being surveilled by the government or a major corporation.

According to a Pew poll from 2019, 81 percent of Americans thought that the trade-off they were forced to make with online companies to give up their privacy was not worth the risk, and 66 percent thought the trade-off wasn’t worth it when it came to the government.

In turn, small companies and state health departments are taking steps that make using an app more difficult in the name of privacy. On the other, years of legitimate surveillance and an onslaught of misinformation has cratered confidence in government tools. There’s a long, uphill battle towards widespread acceptance of these apps.

What’s next for these apps in the US?— The uphill battle continues. Currently, 20 states and territories are developing contact tracing apps.

The fight against coronavirus would be made considerably easier by these apps, and public information campaigns might help. So if you see a celebrity signing about how we “need the BLE” sometime soon, don’t be surprised.